Secondary Traumatization of PTSD Among Children in Military Families

Post-Traumatic Stress Disorder (PTSD) is a psychological condition that affects individuals who have undergone traumatic experiences. Children and adults can experience psychological trauma through violence, sexual assault, natural disaster, or war. The effects of PTSD can be manifested through psychological and behavioral changes, mood and sleep changes. Some of the significant symptoms of PTSD include flashbacks of the incident, anxiety disorder, irritability, agitation, insomnia, social isolation.

However, individuals of all age groups are likely to develop traumatic disorders. Factors such as experiencing intense or lasting trauma, history of mental illnesses, or occupations with highly stressful and traumatic environments such as military personnel can negatively influence the probability of developing PTSD. Military officers and veterans work in highly stressful environments, hence, experiencing different levels of PTSD depending on the armed nature of a given conflict.

Military officers expect to lead an everyday social life upon retirement from official deployment; however, when PTSD is not managed in the military and veterans, their mental and emotional health is negatively affected by living with military personnel living with the mental disorder. Military and veteran personnel officials deployed for combat experience the challenge upon returning home, affecting how officers interact and relate with their families and friends. Family members, especially children, are negatively affected by parental psychological trauma, developing mental disorders known as secondary trauma, secondary traumatic stress, or intergenerational transmission.

Secondary traumatic stress is a consequence of acquiring knowledge about traumatizing events experienced by someone else and the intense pressure from the need to help. The recollection of traumatic events experienced by someone who has undergone great psychological distress is a cause of secondary traumatization.

Historically, most of the soldiers fighting in the Vietnam War were diagnosed with gross stress reaction between 1942 and 1945, commonly known as PTSD. After that, disastrous events such as the September 11th and Oklahoma City bombing have resulted in PTSD among the affected individuals by losing a friend or family member or the survivors’ attacks. The term secondary traumatic stress was developed in the 1990s by Beth Stamm after gaining more perspective on why service providers experienced similar symptoms as PTSD patients without experiencing any direct trauma.

The research will analyze the incidence and degrees of secondary traumatic stress in children. Besides, identify the effects of secondary traumatic stress on children and understand secondary traumatic stress on family functioning using family systems theory. Suppose the secondary traumatic stress manifests in children and is not managed or diagnosed early. In that case, the children’s psychological development is negatively affected, and if the mental disorder is diagnosed early, children are treated and are also taught how to manage the condition. Therefore, the study intends to uncover how parenteral PTSD affects a family’s dynamics, especially children, and its functions.

The study also wants to determine the depth of traumatic stress among children to uncover families’ issues when they experience trauma. The intensity of trauma means displaying how children are affected by STS in the future and psychological development.

Theoretical Perspective

The study addresses the intensity and effects of secondary traumatic stress in children and how it affects family functioning using family systems theory. The family systems theory coined by Dr. Murray Bowen expounded on an individual’s emotional aspect directly tied to a family. Family system theory is the family’s emotional state that affects individuals’ behavior and interconnectedness. People are best understood and studied when connected and are part of a family, and emotional patterns develop within a family. Each family member influences other family members’ behavior and emotions.

Hence, these behavior patterns can lead to dysfunctional or stable families. The interdependency varies among family members; however, there is a unique relational system that centers families allowing family members to rely on the individual. During stressful events, one family member is significantly affected by absorbing everyone’s emotions (Williamson et al., 2018). In traumatic events, this individual is highly likely to develop secondary traumatic symptoms based on another family’s mental state. This theory is nearly essential to this research as it explores how trauma can be adopted and managed by other family members.

This research’s key variables significantly contribute to the effects of secondary traumatic stress experienced among family members. Some determinants contributing to secondary traumatic stress include family projection and the multigenerational transmission process. Family projection is the process where a parent extends their fears and worries to their children by providing extra attention to a child out of fear that there is something wrong. Critically analyze the children’s behavior and action and treat them out of fear, causing more harm in children. The multigenerational transmission process is where children develop a high sense of self than the parents creating small differences with minimal connection, causing a drift.

There’s a significant challenge in addressing trauma transmission from parents to children among military families. According to Nolan (2019), technology can address these challenges by allowing military parents to recover from PTSD before reuniting with their families by integrating technology to improve parenting skills. The technology invention will be sufficient for military families requiring social programs to improve mental health. Military outreach programs can put strategic initiatives in place to reduce secondary traumatization among military families’ children.

Literature Review

Post-Traumatic Stress Disorder (PTSD) is a mental state whose effects extend to families and close friends. Military officials deployed for combat experience mental health challenges once returning home, hence, transferring the trauma to their children. Humans are characterized by various physical, behavioral, and psychological features that occur during phases throughout human life, from infancy to old age. Behavioral reactions develop since three months old and can express excitement, surprise, or distress in children. By one year, the babies have social and emotional development and form attachments towards their caregivers.

The growth of a child’s mental, social, and emotional aspects is highly influenced by the environmental factors rather than internal factors such as personal characteristics. Cultural, social, and socioeconomic elements influence the overall development, affecting the values, customs, confidence, learning abilities, and how children relate to their parents. At age 11, children have the fully developed brain’s cognitive aspect and can critically analyze concepts, plan systematically, and reason logically.

However, when children’s mental growth is interrupted by a traumatic experience, the brain’s cognitive function alters the memory, processing emotional or social information, and attention span, sometimes delaying cognitive function development. PTSD is closely linked to the brain’s mental growth and functions; hence, it is essential to address childhood trauma. Military people are at high risk of developing psychological health disorders such as PTSD, consequently extending their family members’ traumatic experiences, especially children (Cramm et al., 2018). Children of deployed parents develop psychosocial and behavioral challenges negatively affecting the relationship between child and parents.

Some of the behavioral changes associated with secondary trauma stress include social withdrawal, nightmares, reduced academic performance, feelings of sadness and loneliness, and anger. This behavior change is commonly known as a military family syndrome (Fear et al., 2018). Children’s well-being is vulnerable during infancy and early ages. It determines behavioral attributes in the future—adults suffering from social relations such as interaction and public speaking encounter parental challenges at a young age. Parental responsibilities are crucial for children’s comprehensive growth; therefore, deploying both parents to military assignments affects parental competence once they return (DeVoe et al., 2018). Most fundamentally, the parent’s child bond is torn, leaving a gap in a child’s life with feelings of abandonment affecting parents’ childrearing capabilities.

Officers reuniting with their families from battlefields return home mentally disturbed due to their traumatic experiences in war. During a battle, the psychological scar causes emotional unavailability to children upon reuniting with families due to war violence’s constant exposure. Hypervigilance is a mental health consequence in a combat-ready environment. Excessive anxiety presented through emotional distress in veterans who return home from combat unknowingly transmits PTSD to family members close to them, such as children or spouses (Chesmore et al., 2018). Military personnel experiencing PTSD requires care that helps them cope with the outside world after retiring.

Families of ex-military parents need information and social support to lead a successful family life after assignments, improve parenting skills, and become functioning citizens (Turgoose & Murphy, 2019). Improving parental ability highly relies on treating and recovering from mental disorders, post-traumatic events. PTSD treatment calls for resilience among military mothers and fathers, and not all veterans are willing to take medicine due to the stigma surrounding mental health (Horn & Feder, 2018). Cognitive Behavioral Therapy (CBT) is a standard treatment among patients with PTSD.

The therapy ensures the recovery of mental abilities such as informed decision-making and problem-solving. The CBT model can help military and veteran families improve parenting responsibilities and provide closeness and open communication in the family, significantly reducing secondary trauma in children. Family roles are vital social responsibilities among military parents getting deployed to armed conflicts (Ridings et al., 2019). Recovering from PTSD after return from battlefields requires objective strategies that integrate technology invention. This technology would be sufficient for military families needing social programs to improve mental health. It is fundamental to identify strategic initiatives to mitigate secondary traumatization among military families’ children.

Conceptual Framework

The structural model of child well-being.
The structural model of child well-being.

The structural model formed by Bronfenbrenner, Leont’ev, Cobb, and Vygotsky examines a child’s well-being as a process rather than an outcome. The structural model identifies the four most critical aspects of a child’s prerequisites: physical, social, mental, and material. Internal conditions in children are adopted hereditary or developed due to social competence. Physical well-being examines the physical attributes which determine the absence of disease.

In contrast, mental well-being explores the lack of mental disabilities and a child’s subjectiveness and emotional well-being (Minkkinen, 2013). Social and material well-being is the overview of the child’s relationships with parents and friends and the material aspect of sufficient food and housing respectfully. The model explores a child’s growth in the various dimensions on societal and individual levels.

Children’s well-being and prosperity are straightforwardly identified with their families’ capacity to give their fundamental physical, passionate and social requirements. Subjective action refers to the children’s exercises that produce prosperity or activities that corrupt prosperity, such as risk behavior. Precisely, inner movement eludes mental cycles, such as insight, thinking, and memory, while outside action alludes to reasonable activities.

The societal aspect of child well-being is categorized into the circle of care, culture, and society’s structure. The circle of care refers to those individuals communicating directly with children and their physical, psychological, and material help (Minkkinen, 2013). The odds of children enduring and getting to adulthood are minimal without others’ material help. Yet, the extensive exploration of information underlines social support as a significant supporter of well-being.

Structures of society affect a child’s growth by influencing their ability to interact with other community individuals. These social skills are affected by the educational background, family structure, and healthcare. Culture is the outermost and the most expansive aspect that affects every part of a child’s well-being. The culture predetermines values, norms, habits, and attitudes. The structural model of child well-being plays a critical role in exploring children’s dynamics suffering from secondary trauma.

Research Questions

  1. What is the incidence and degree of secondary traumatic stress in children?
  2. What are the effects of secondary traumatic stress on children?
  3. How does secondary traumatic stress affect a family’s functioning using family systems theory?

Research Design and Rationale

The study will be based on a descriptive and numerical phenomenological approach, where relevant data will be collected using interview questions. The standard research designs include qualitative, quantitative, and mixed-method research; this study adopts the mixed method that consists of both descriptive and numerical data. The use of qualitative research alone limits the interpretation of findings causing it to be time-consuming. Participants’ knowledge and experience largely influence observations made from the study. The study may take longer to be complete, especially when data is collected through the face-to-face approach. This study’s nature may trigger secondary trauma in children and parents, limiting the researcher’s information.

It is essential to capture the data using quantitative research, which examines the frequency of secondary trauma in children and the severity of the research problem. Quantitative data explore in-depth information about the study with minimal biases and accuracy (Bloomfield & Fisher, 2019). Qualitative and quantitative studies align with constructivist and interpretive research, where data is collected through interviews, narratives, and focus group discussions. Face-to-face interview questions are used in this study to collect data aimed at answering the formulated research aim and objectives. Mixed method research will enable the researcher to complement each research design’s strengths and weaknesses and develop an in-depth study that addresses the questions.

Sample Selection

Sampling entails recruiting participants from a research interest population to participate in the study. Sampling is obtaining a representative taste from a group being studied. In this research, the research interest population includes military families with deployed spouses, children with both parents deployed, and ex-veteran parents with PTSD through the local veteran organizations. Due to the number of veteran families, this study will focus on at least five veteran families under the stated categories; children with both parents’ deployed, military facilities with deployed spouses, and ex-veteran parents with PTSD. The researcher will aim to sample a representative number of participants to explore the formulated research aim and research questions. Snowballing sampling is a non-probability sampling technique that will be used to recruit veteran families affected by PTSD of a parent into this study with the intentional selection of requesting participants to nominate other subjects.

Additionally, to minimize snowballing biases, stratified sampling will be used in the equal selection of local veteran organizations in the community to analyze the effects of PTSD on children in military families (Ghaljaie, Naderifar, & Goli, 2017). Stratified sampling focuses on grouping a more extensive population into subgroups with similar characteristics, for instance, teenagers with veteran parents experiencing PTSD. The sample selection is limited to military families affected by a parent or partner’s traumatic experiences. Specific focus aims to obtain responses from the local veteran organization, spouses, and children of military personnel based on whether the military personnel’s incidents have influenced the family dynamics, degree of severity, and secondary trauma on children.

Rationale

Inclusion and Exclusion Criteria

Military-based families with a history of partner history of PTSD, children with secondary traumatic stress, and teenagers or adults who experienced secondary traumatic stress due to their parents’ PTSD will be included in the research paper.

Civilian families, Veteran couples with no children but experience secondary traumatic stress, and families with a deployed member who has no history of trauma will be excluded from this study.

The Ideal Number of Participants

The selection of the ideal number of participants includes 15 participants for this study. Out of the fifteen participants, five of them will be ex-military parents experiencing PTSD, five children experiencing secondary trauma, and children with both parents deployed with a history of PTSD, respectively.

Recruitment and Informed Consent

The use of human subjects in this study raises potential ethical questions and concerns that need to be examined. The main moral problem emerging from this study is participant consent. Before engaging in the data collection process, the researcher will seek relevant participant consent from the interviewees. Analysts will send a participant consent form to the participants to inform them about the research’s intention and request their approval before taking part in the interview sessions. Besides, analysts will obtain relevant ethical permission from the institutional ethics board before embarking on the study process.

The study will address issues associated with the participants’ privacy and confidentiality data. The data collection process will not capture any personal information that would make it easier to reveal its identity. For instance, the researcher will avoid collecting personal information such as contacts, names, or residence. Potential participants will be recruited in various ways, such as reaching out to local veteran organizations, word of mouth, and military outreach programs. Recruitment of participants will be done voluntarily and correspond to the inclusion criteria highlighted in this study. Participants are free to discontinue or drop from the study at any time without any negative consequences.

Data Collection

Data collection will be conducted through face-to-face interview sessions lasting an hour to an hour and a half. All interviews will be audio-recorded and conducted through pre-scheduled sessions. The focus will be to collect views and personal experiences from the participants regarding the effects of PTSD parents on a child’s psychological development. The use of face-to-face interviews in collecting information gives more in-depth data from participants concerning the research area being explored. The researcher will seek clarification on shared insights from the interviewees. There is a minimal chance that interviewees will share inaccurate information; however, they might withhold information due to this study’s sensitivity.

The interview data collection method allows the researcher to capture verbal and non-verbal cues. An interview session makes it possible to capture how individuals express themselves regarding the phenomenon under study and signals such as body language indicating discomfort with the interview questions. The researcher will collect the collected data in a safe room with minimal distraction then securely stored it in a password-protected computer to limit unauthorized individuals’ access. The data collected will also be backed up into Google Drive using a password-protected email account to secure them and ensure the researcher could retrieve the raw data for a period of up to 5 years.

Reliability and Validity

The current section elaborates on the scientific quality of the data in terms of rigor and validity to ensure the study’s findings will be reliable—fact relating to quantitative study methods. Nonetheless, qualitative researchers argue that the name is suitable for all paradigms as a generic term to show that research conclusions are sound and well-founded. Researchers can assess scientific reliability based on how the research is presented to the readers and appraising research bias with both the researcher and the interviewees. Therefore, clarity concerning various methodological principles that are used becomes a fundamental necessity. The need for strategies to ensure validity and rigor and that the designs need to be anchored on the research process and not solely assessed after the study is essential (Mohajan, 2017). This section discusses how the research ensures scientific rigor and validity as it applies to data transfer, credibility, and reflexivity.

Reflexivity is closely linked to previously discussed methodological principles of reflexive attitude and questioning individual pre-understanding. In this study, reflexivity is maintained during the entire research process, and the researcher needs to enhance an instinctive attitude when assessing information collected from the interview sessions. Specifically, reflexity included questioning the understanding of themes and data derived from the interview responses. The researcher closely engages in this process and continuously reflects on what the data states explicitly, which may differ from the researcher’s prior understanding of the topic. In elaboration, this means that the researcher has to question the study’s findings instead of taking them at face value.

In contrast to reflexibility, credibility refers to the significance of the results and whether the obtained data is well presented in line with the research aims and objectives. Reflexivity and credibility are not largely distinct but are closely correlated with one another. Credibility seeks to emphasize that every piece of information needs to be accorded severe consideration and evaluation and is associated with eliminating potential bias resulting from data presentation and analysis.

Analyzing data needs to be open and transparent, which means that the information needs to be presented thoroughly to achieve credibility. In this study, the researcher will ensure practical methodological considerations and decisions to achieve data transparency. The researcher will also provide thematic analysis and information evaluation reflecting the themes identified from the primary interview data, where descriptions are consistent and clear throughout the analysis process. Data credibility is achieved through the methodology and information presentation. Thus, in working towards credibility, the researcher ensures that the methods and procedures are transparent and thorough.

Transferability describes the relevance and usefulness of the study findings. Nonetheless, the method used to ensure transferability may not help establish the results’ generalizability. Transferability is not associated with methodological principles as the case with reflexivity and credibility but may emerge due to their processes. Transferability will be used to measure whether the obtained results are sound. The current study adds new knowledge to the extant literature on secondary traumatization of PTSD among children in military families. Besides, the clarity of the results will be considered an essential aspect of achieving results transferability. In return, the data collected will need to be relevant and recognizable to a broader or specific context different from the original study. The purpose, functionality, and relevance of the study findings to other studies are critical aspects of the research findings’ transferability.

Data Analytic Plan

The data analysis focuses on comprehending the complexity of meanings derived from the data instead of measuring their frequency. In this study, the researcher engages with the data and the analysis processes. The collected data will be analyzed using the Nvivo statistical software, critically evaluating the text and audio-based information compiled into useable data and delivering comprehensive findings. The collected data will be transcribed verbatim and analyzed to identify the main themes emerging from the study. This study will use the Nvivo analysis software to identify specific concerns based on the descriptive approach. The software will dissect the original data to determine the data’s meanings and patterns into finding correlations to the study’s aim and context.

References

Bloomfield, J., & Fisher, M. J. (2019). Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), 27-30. Web.

Chesmore, A. A., Piehler, T. F., & Gewirtz, A. H. (2018). PTSD as a moderator of a parenting intervention for military families. Journal of Family Psychology, 32(1), 123–133. Web.

Cramm, H., Murphy, S., Godfrey, C. M., Dekel, R., & McKeown, S. (2018). Experiences of children exposed to parental post-traumatic stress disorder while growing up in military and veteran families: A systematic review protocol. JBI Evidence Synthesis, 16(4), 852-859.

DeVoe, E. R., Kritikos, T. M., Emmert-Aronson, B., Kantor, G. K., & Paris, R. (2018). Very young child well-being in military families: A snapshot. Journal of Child and Family Studies, 27(7), 2138-2148.

Fear, N. T., Reed, R. V., Rowe, S., Burdett, H., Pernet, D., Mahar, A., Iversen, A. C., Ramchandani, P., Stein, A., & Wessely, S. (2018). Impact of paternal deployment to the conflicts in Iraq and Afghanistan and paternal post-traumatic stress disorder on the children of military fathers. The British Journal of Psychiatry, 212(6), 347-355.

Ghaljaie, F., Naderifar, M., & Goli, H. (2017). Snowball sampling: A purposeful method of sampling in qualitative research. Strides in Development of Medical Education, 14(3). Web.

Horn, S. R., & Feder, A. (2018). Understanding resilience and preventing and treating PTSD. Harvard Review of Psychiatry, 26(3), 158-174. Web.

Minkkinen, J. (2013). The structural model of child well-being. Child Indicators Research, 6(3), 547-558. Web.

Mohajan, H. K. (2017). Two criteria for good measurements in research: Validity and reliability. Annals of Spiru Haret University. Economic Series, 17(4), 59-82. Web.

Nolan, J., Lindeman, S., & Varghese, F. P. (2019). Mobile app interventions for military and veteran families: Before, during, and after deployment. Psychological Services, 16(2), 208. Web.

Ridings, L. E., Moreland, A. D., & Petty, K. H. (2019). Implementing trauma-focused CBT for children of veterans in the VA: Providing comprehensive services to veterans and their families. Psychological Services, 16(1), 75. Web.

Turgoose, D., & Murphy, D. (2019). A systematic review of interventions for supporting partners of military veterans with PTSD. Journal of Military, Veteran and Family Health, 5(2), 195-208.

Williamson, V., Stevelink, S. A., Da Silva, E., & Fear, N. T. (2018). A systematic review of well-being in children: A comparison of military and civilian families. Child and Adolescent Psychiatry and Mental Health, 12(1), 1-11. Web.

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StudyCorgi. 2022. "Secondary Traumatization of PTSD Among Children in Military Families." September 15, 2022. https://studycorgi.com/secondary-traumatization-of-ptsd-among-children-in-military-families/.

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